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目的探讨超声引导下经皮肺穿刺活组织检查(简称活检)肺周围型病变的应用价值。方法选择昆明市延安医院肺部疾病患者161例,其中男性112例,女性49例;年龄14~78岁,平均年龄53.0岁。行超声引导下经皮肺穿刺活检,分析取材满意程度及并发症发生情况。结果 161例病灶均穿刺成功,成功率100%,确诊病灶158例,确诊率98%。肺结核43例;肺癌及转移性肺癌91例,其中腺癌34例,鳞癌42例,支气管肺泡癌2例,大细胞肺癌4例,小细胞肺癌3例,淋巴瘤3例,间皮瘤3例;肺炎性病变24例,其中培养出耐酶金黄色葡萄球菌2例,隐球菌2例,绿脓杆菌9例,曲霉菌3例,大肠埃希氏菌3例,鲍曼不动杆菌2例,3例培养无阳性结果。并发气胸1例(0.6%),咳血35例(21.7%)。结论超声引导下经皮肺穿刺活检肺周围型病变病理组织阳性率高,取材满意率高,并发症少,是一种安全、可靠的确诊手段,值得临床推广。
Objective To investigate the value of ultrasound-guided percutaneous lung biopsy (referred to as biopsy) pulmonary peripheral lesions. Methods 161 cases of lung diseases in Yan’an Hospital of Kunming were selected, including 112 males and 49 females, aged from 14 to 78 years with a mean age of 53.0 years. Under the guidance of ultrasound-guided percutaneous lung biopsy, the degree of satisfaction and incidence of complications were analyzed. Results All the 161 lesions were successfully punctured. The success rate was 100%. The number of confirmed lesions was 158, and the diagnosis rate was 98%. 43 cases of pulmonary tuberculosis and 91 cases of lung cancer and metastatic lung cancer, including 34 cases of adenocarcinoma, 42 cases of squamous cell carcinoma, 2 cases of bronchial alveolar carcinoma, 4 cases of large cell lung cancer, 3 cases of small cell lung cancer, 3 cases of lymphoma, 3 mesothelioma Cases; pneumonia lesions in 24 cases, which were resistant to Staphylococcus aureus 2 cases, Cryptococcus 2 cases, Pseudomonas aeruginosa 9 cases, Aspergillus 3 cases, Escherichia coli 3 cases, Acinetobacter baumannii 2 For example, 3 cases had no positive result. One case of pneumothorax (0.6%), hemoptysis in 35 cases (21.7%). Conclusion Ultrasound-guided percutaneous lung biopsy of lung lesions around the pathological positive rate, high satisfaction rate, fewer complications, is a safe and reliable diagnostic means, worthy of clinical promotion.